Individual
PAUL RICHARD SULLIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1950 MOUNTAIN VIEW AVE, LONGMONT, CO 80501-3129
(303) 306-7783
(303) 306-7753
Mailing address
PO BOX 1175, ENGLEWOOD, CO 80150-1175
(303) 306-7783
(303) 306-7753
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
37307
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01373075
—
CO
01
—
930078351
RAILROAD MEDICARE PIN
CO
Enumeration date
12/22/2005
Last updated
03/06/2014
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